Tan Wu Meng
Singapore
“So, if I may just recall briefly what I said five years ago during the debate on the President's Address. Healthcare is about all our people's lives, your life and mine, the lives of our loved ones, the life of every Singaporean. And with that, let us all hope for healthier and happier lives together.”
“Mr Chairman, I thank all who contributed to this debate. Our MOH leadership and MPs of all persuasions. Also want to express deepest thanks to our entire healthcare family, our front liners, the support team and our public officers. If I may briefly seek the indulgence of Speaker —”
“I thank the Ministry of Transport (MOT) for sharing that there are plans to introduce regulations to address the issue of online shops selling AMDs that are in breach and unsafe.”
“The online Community Justice and Tribunals System brings convenience to those who can go online. What happens to seniors who are less digitally-savvy, less literate or who may not be so familiar with the English language?”
“Mr Speaker, I thank MOE for this move. On the topic of social capital and social network diversity, can I ask the Senior Parliamentary Secretary that for these studies, will MOE look at it much further into the future?”
“Mr Speaker, I thank the Minister of State for her answer. My Clementi residents shared with me that they discovered their child was vaping. Because they did not know what to do, they brought their child to the nearest Police station. The Police referred the case to HSA and the child was issued with a $300 fine for vaping.”
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“So, if I may just recall briefly what I said five years ago during the debate on the President's Address. Healthcare is about all our people's lives, your life and mine, the lives of our loved ones, the life of every Singaporean. And with that, let us all hope for healthier and happier lives together. I beg leave to withdraw my amendment. [(proc text) Amendment, by leave, withdrawn. (proc text)] [(proc text) The sum of $18,795,327,500 for Head O ordered to stand part of the Main Estimates. (proc text)] [(proc text) The sum of $2,067,888,400 for Head O ordered to stand part of the Development Estimates. (proc text)]”
“Mr Chairman, I thank all who contributed to this debate. Our MOH leadership and MPs of all persuasions. Also want to express deepest thanks to our entire healthcare family, our front liners, the support team and our public officers. If I may briefly seek the indulgence of Speaker —”
“I would like to thank the Minister for Health, and I just wanted to raise some questions on our approach to value-based care, which is really another way of saying "getting value for money", part of fiscal discipline and fiscal prudence. And can I ask MOH if, moving forward, there will be even greater attention given to how we measure value, not just in terms of a single Ministry policy at one point in time, but also looking at how it may shape the situation for the family. So, for example, if additional manpower and resources are needed so that a particular patient does not have to attend 36 appointments a year, but let us say, down to 18 or 12, those resources in streamlining and coordinating care can be looked in context of reducing the effort needed by the caregiver who accompanies the patient. Because, as I have said during the Budget debate, this can determine whether the caregiver goes from full-time to part-time employment, or whether a caregiver on flexible work leaves their career completely. And, therefore, the support to the patient can also be considered in terms of the outcomes for the family unit and the family unit's ability to continue being in employment.”
“If the situation is serious, they can go and see a clinical assessment, whether a psychologist or an informal medical consult, but at least there are more options there, even while MOH works out the issues with the insurance companies. In short, as I said five years ago in Parliament, sometimes the invisible hand of the market becomes unbalanced. And that is why we need the visible hand of the regulator to re-shape insurance behaviour and ensure proportionate, fair and more reasonable decisions on insurance for young Singaporeans who have gone through a mental health situation. Sir, in the Budget debate, I made three points. Firstly, if implementation is policy, then the residents' journey is implementation and I will add that the patients' journey is implementation too. Second, Government spending must look not just at a single item on a budget, but the broader impact to society, because sometimes, spending on coordination of care becomes an enabler, a catalyst to help a family, and sometimes save a breadwinner's job. Lastly, technology must serve the people. People must not bend to serve technology or the design of technology. These principles apply not just in a budget, but across the whole-of-Government and in MOH as well. So, I call upon MOH to consider our suggestions as we aim towards healthier, happier lives for the people of Singapore and our future. [Applause.] [(proc text) Question proposed. (proc text)] Workload of Junior Doctors”
“Second, front load Government funding for young cancer patients needing fertility support, because a MediSave-based model does not work so well when the patient is too young to have earned MediSave from working and when the patient's family might not have much MediSave, if the family is starting with less. Third, work with financial institutions to see if we can have interest-free loans to support young cancer patients needing fertility preservation. Fourth, support philanthropy in the fertility preservation for young cancer patients. Seven years ago, I spoke up in Parliament for children with rare diseases. The Government later set up a Rare Disease Fund with three-to-one matching grant for public donations. Can MOH learn from this model, learn from this journey, to better support philanthropic efforts to help young cancer patients? Let me also speak on mental health. Last year, I spoke about access to insurance. I shared about young Singaporeans who are afraid to seek help in a mental health crisis because they are worried that once a diagnosis is on the record, some insurers will not cover them even for conditions unrelated to mental health. One Clementi resident said to me: "Dr Tan, some insurers are kind, but some are one kind", and indeed, we have to make sure that there is not such market failure. At the same time, can MOH also improve access to non-clinical, more community-based mental health support, so that young Singaporeans with mental health worries can find help in the community without necessarily having to go to a healthcare setting.”
“Are we giving the same attention to IT that the big firms, like Apple and Google do? As I said in 2022, technology must serve the people. Technology must serve, adapt and bend to the person, not getting our people to bend to the technology. And indeed, over the years I have spoken up for our healthcare workers, and in fact, as far back as 20 years ago in the SMA News, I and my fellow junior doctors had been advocating to improve the junior doctor journey, because our junior doctors are the future of our profession – and when we lift up, empower our juniors to do better, to be change agents – it lifts up the profession, it lifts up patients as well, it lifts up the care and quality of care in our community. On healthcare financing, I want to speak about support for patients and how financing decisions shape behaviour. Last year, just before National Day, I spoke in an Adjournment Motion on fertility preservation support for young cancer patients. Every cancer patient goes through a difficult time, but for the very young patients, those who have yet to even start a family, it is especially stressful because certain treatments, while life-saving, can damage fertility, take away the dream of a family even before someone has a chance to start. Working with a number of young healthcare workers across different hospitals, different clusters, we called upon MOH to look at four recommendations to help young cancer patients on the fertility journey. Firstly, for MediShield Life to cover fertility preservation for young cancer patients undergoing medically necessary treatment that will damage fertility irreversibly. If MOH moves on MediShield Life, this can be the first step to getting the Integrated Shield Plan insurers on board too.”
“So, coordination is not just a cost centre or an expense, it is an investment, it is a catalyst, it is an enabler to help families with worries about caregiving. If we bring in social support agencies as well, so that more of the care can be done in the community, it can even be a pilot project for the Bureau of Service Simplification (BOSS), which I proposed during the Budget debate, and perhaps MOH and the Minister for Health can be part of this pioneering initiative to simplify the journey for citizens across healthcare, social care and citizen journeys. In short, recognise patient navigation and coordination, not as a cost centre, but as an investment, an enabler and a catalyst. The backend work of coordination takes time, energy bandwidth and our sisters and brothers in the HSEU have shared this as well. So, even as we invest in coordination, we have to recognise the hard work that healthcare frontliners put in to streamline care, coordinate care, wrap care around the patient. And we know from our sisters and brothers that sometimes this includes work taking place outside of duty hours and we should find ways to measure, recognise and factor this into our workforce planning. I also call upon MOH to look at healthcare information technology (IT), because when there is a gap between what the software is and what we want it to be, it is technical debt. Healthcare workers, patients trying to navigate systems and computers. So, can MOH tell us what is being done to improve healthcare IT to help frontliners, including our junior doctors? Is AI being used to simplify the work for healthcare frontliners so that people can spend more time delivering care, caring for patients rather than navigating computer systems?”
“It comes with an ageing population, multiple doctors, multiple teams looking after the patients, sometimes the care is complex – many experts, many teams looking after the same patient – and so coordination is even more important today, and it is especially important when the care is complex. I raised this 16 years ago, in the year 2009, in an article in the Singapore Medical Association newsletter, SMA News, and again more recently, in the 2022 MOH Budget debate Committee of Supply (COS). In Government, in the Cabinet, we have Coordinating Ministers. That tells you that at the highest levels of Government, we recognise coordination is an important role and adds value beyond a single specialisation. So, for patients with multiple complex medical conditions, can there be a coordinating doctor supported by different specialists from medical, nursing, allied health, also with adequate admin support, so we can wrap care around the patient with complex needs. This can simplify the care journey, fewer visits to clinics, especially if the care can be coordinated backend. In a previous PQ that I filed, MOH shared that just before the COVID-19 pandemic in 2019, there were 7,000 Singaporeans a year, with 24 or more specialist outpatient clinic visits in a year. That means two or more specialist outpatient visits in a month. In the year 2019, there were over 2,000 Singaporeans who had 36 or more outpatient clinic visits to a specialist clinic in a year, three or more visits per month on average. Imagine the impact on caregivers who do not have flexible working arrangements (FWAs), or who have loss of income when they accompany a patient, their loved one, for care.”
“And so, it means that the residents or the patient with the best digital access, fastest fingers, sharpest eyes, quickest with their smartphone or their computer, they are the ones who "chope" the appointments. The seniors who find it harder to navigate a website, find it harder to go online, they are stuck. They find it very difficult. Sir, this can be regressive towards the elderly and the less digitally-savvy. The systems made it harder for these seniors. And I have met elderly residents who tell me when they show up at the polyclinic without an appointment, sometimes they get turned away, asked to go online to make a booking, even though they do not know how to go online. Or sometimes, they are told to go and visit a nearby general practitioner (GP) clinic, even though this might cost more than the polyclinic, and for retirees without income, retirees of limited means, every extra dollar spent on healthcare is one more dollar drawn down from their retirement savings. In 2024, I filed a Parliamentary Question (PQ) to MOH. I asked MOH to consider portable subsidy vouchers to help underwrite some of the cost difference between polyclinic care and private GP care, especially for seniors who may physically live right next to the polyclinic, nearby the polyclinic, but who due to digital challenges, find it very hard to go online to book an appointment for the next day at the polyclinic. Can MOH take a look at this again, as an interim measure, while the agencies continue working to improve polyclinic capacity and better support our healthcare sisters and brothers on the polyclinic healthcare front line. Let me also speak about healthcare processes now, in particular, care and coordination. Today, we know many seniors have multiple medical conditions.”
“This will help patients with chronic diseases who have to undergo certain types of scans and if we enhance access to outpatient MediSave for scans, it will help cancer patients as well, who often have to go for regular scans as part of their treatment plan and monitoring. Let me also speak about access to care, not just the finances, but also the process of getting to the care. Let me speak about digital access and our polyclinic system. In the old days, patients would go to a polyclinic. They would queue and wait to be seen. That had its own challenges, but in recent years, there has been digitalisation at polyclinics nationwide. I have older Clementi residents who share with me that, while this has brought modernisation, it has brought challenges for some of our older residents as well. In particular, we must avoid the phenomenon of digital drop-off when we go digital with healthcare, digital drop-off when patients who previously had access to care no longer show up, not because their healthcare conditions have gone away, not because their problems have been solved, but because they find it too hard to navigate a digital system to secure access to healthcare, or even a healthcare appointment. One worry that my Clementi residents share about is how they have to go online to book an appointment at an offline consultation in the polyclinic. I have had Clementi residents, but even residents staying in the east of Singapore, writing to me to share about these challenges. They find that when the bookings open at 10.00 pm, in the case of some polyclinic systems, the online bookings get "choped", get reserved, very quickly within a few minutes. These are the bookings for the next day's consultation.”
“As part of a treatment plan, she needs to go to a clinic every day to take her medicines under direct healthcare supervision in a healthcare setting. It is called Directly Observed Therapy (DOT). But because his wife is ill and in a wheelchair, he has to push her in a wheelchair to the polyclinic every day for the daily medicines. My resident is a dutiful and loyal husband. At the same time, his job cannot be done remotely, so he quit his job to support his wife, quit his job so he could bring his wife in a wheelchair to the polyclinic each day for DOT, to take medicines that have to be given under healthcare supervision. Could there have been a way for my resident's wife to receive her medication at home? Could there have been a way for the system to support my resident's family better, so that the husband did not need to have to choose between keeping his job and making sure his wife got treatment every day? Could the treatment have been delivered in the home itself? Because when we help the patient, it can help the caregiver, and if by saving the caregiver's job, it helps the family as well. Let me speak about outpatient scans, because today, more and more care can be delivered in the outpatient setting. People are getting older with more complex medical conditions. Healthcare is advancing and with advances in care, the use of scans is more common nowadays. 3.15 pm Can MOH be more flexible with the use of MediSave for outpatient scans? Can we make it easier to access patients' MediSave for such scans, which may be medically necessary?”
“Mdm Chair, I seek to move, "That the total sum to be allocated for Head O of the Estimates be reduced by $100". I declare I am a medical doctor in a public hospital, looking after cancer patients. I am also an advisor to the Healthcare Services Employees' Union (HSEU). Chair, SG60 is a time to look back and look ahead, and the same applies for our healthcare system as well. It is time for us to reforge, remake new foundations and move forward with new foundations for the future. Let me start by speaking about right-siting of healthcare. Right-siting, which means place of care, subsidy of care, access to care. In 2022, I called for the Ministry of Health (MOH) to look at how care can be brought closer to home for patients, especially for residents who are less mobile, who find it more difficult to get to clinics. If the care has to be in a hospital, there should be a medical reason, not because the subsidy and access to funding is tied to the hospital or to the specialist outpatient clinic. In short, bring subsidy to where the patient is, if the policy intent is to support the care where the patient is. There has been progress in the years since then, improved access, also better financing support for palliative care at home, which is important for residents who are terminally ill, where time is even more precious than before, and where being at home in their last weeks and months is deeply important. But there is room to do further and do even better as we remake our healthcare system. Let me speak about home medical care. One of my Clementi residents met up with me and my team. He is a husband looking after his wife who is ill. His wife is a young mother, with a lung infection, with tuberculosis and she just got out of the hospital.”
“In this vein, do we know if the same portal vendor and the same security reviewer are providing services to any other Government portals or Government organisations?”
“I thank the Senior Minister for the Ministerial Statement. I have asked two Parliamentary Questions on the same topic in January. My clarifications will fall into two buckets. The first on mindsets and instincts. The second on IT security. Sir, firstly, on mindsets and instincts, can I ask, in hindsight, could there have been earlier involvement of agencies with a specific security mindset when the new Bizfile portal was being designed and implemented? In particular, does the Senior Minister agree that in the modern era, we must assume that any database with a search function will attract cyber troublemakers trying to download and scrap as much of the information as possible? And as such, how can we further strengthen the instincts or even the sixth sense within agencies and officers to be more sensitised to these dangers, especially for databases that contain NRICs, because the NRIC number is unique and cannot be changed? Once it is being harvested, that bell cannot be unrung. Secondly, on IT security, can I ask the Senior Minister is there room to strengthen the red team capability and the use of red teams within the Government to look at the security of online portals that might provide access to personal data even through a search function, especially for projects where there is a greater risk if there is a security glitch? For example, and I have read the report, it mentions that ACRA outsourced the portal security to the portal vendor. The vendor then outsourced security penetration tests to a security reviewer. And yet, when GovTech came in, they discovered that the security features were not adequately implemented.”
“I thank the Ministry of Transport (MOT) for sharing that there are plans to introduce regulations to address the issue of online shops selling AMDs that are in breach and unsafe. Can I ask MOT whether as part of the regulation review, they will be looking at how liability is assigned when a device has been purchased from an online shop, and let us say subsequently, there is a fire. In short, does the Ministry agree that the liability should not be any different regardless of whether the item was bought from an online retailer or from an offline, brick and mortar real world retailer? Because the fire burns as hot and as damaging, regardless of where the defective product came from.”
“The online Community Justice and Tribunals System brings convenience to those who can go online. What happens to seniors who are less digitally-savvy, less literate or who may not be so familiar with the English language? What happens if these seniors want to access the Small Claims Tribunal or Protection from Harassment Court or other services under the CJTS? Does this mean the digitally disadvantaged may inevitably face an uneven playing field when it comes to accessing community justice with all these new digital platforms? Sir, digitalisation must not become a digital divide. Digital justice must not become difficult justice for the non-information technology (IT) savvy. We must avoid digital dropout where a case with merits is abandoned, because a senior found it too hard to access digital processes.”
“Mr Speaker, I thank MOE for this move. On the topic of social capital and social network diversity, can I ask the Senior Parliamentary Secretary that for these studies, will MOE look at it much further into the future? That means looking at the cohort, not just as they progress through school but to the end of formal schooling, and even into the early years of working life, so that we can see how this lifts up children, not just at age 18, but even at 28 or 38 in the years ahead?”
“I thank the Minister for her comprehensive answer. I have Clementi residents who followed this news and were understandably concerned that there were reports of food poisoning in conjunction with certain RTE meals. I have got two sets of supplementary questions for the Minister. Firstly, based on media reports, these are ambient RTE meals, which means they were described as not requiring any special storage or refrigeration and could be eaten straight away. There were media reports that described the meals also as having real-time shelf-life studies. Can I ask as part of these shelf-life studies, under what kind of storage temperatures the testing was done to test the shelf-life? And did these storage temperatures reflect the variation that can happen when such meals are stored in the community for longer periods of time? Because weather can be warmer when these meals are being stored in a venue that may have sunlight coming from time to time, and so on? Secondly, can I also ask regarding the cases that have been found, were there any cluster effects, clustering of cases besides the one at SOTA, as that may help agencies understand if particular batches were affected, or if there may have been some other concurrent infection outbreak happening?”
“In short, Mr Chairman, we must send a clear message to scammers, the syndicates and those who abet them, if you mess with our people, make off with the life savings of Singaporeans, scams Singaporeans, we must do everything in our power to teach the scammers a lesson they would not forget. Will the Minister send that message to the scammers and those who assist them in taking our residents' life savings?”
“My Clementi resident got scammed, life savings gone. She faces bankruptcy and if so, she will lose her job. The scammers used a local bank account. Someone in Singapore allowed their bank account to be used as a runner's bank account to take my resident's money, send it overseas beyond retrieval. How many money mules or scam runners actually get caught? Look at the numbers. The runners have done their calculations and many are not deterred. Last year, scam cases went up 10% year on year, but can MHA's Anti-Scam hotline and the Anti-Scam Command, can they hire 10% more officers every year indefinitely? A very serious problem calls for very serious measures. Let us look at how the government has handled unlicensed moneylending. The Moneylenders Act states that if someone's bank account is used to facilitate unlicensed moneylending, they are deemed to have assisted the illegal business. Offenders can face jail, fine or even caning. Today, if a loan shark runner handles $10,000 of cash, taken from a victim, they can be caned. But a scammer or scam runner, if they make off with $100,000 of someone's life savings, from a scam victim, they cannot be caned. I have Clementi residents wondering, is Singapore too soft on scammers? Because given this discrepancy, we need to harmonise and send a clear message. I call upon the Minister for Home Affairs to allow caning as a punishment for scammers, especially the egregious cases. One possible model for the most egregious cases, mandatory caning. Let us say the runner knew it was organised crime, knew the bank account would be used to take people's money for scams and send it overseas. For intermediate cases, discretionary caning, depending on the facts of the case.”
“Mr Speaker, I thank the Minister of State for her answer. My Clementi residents shared with me that they discovered their child was vaping. Because they did not know what to do, they brought their child to the nearest Police station. The Police referred the case to HSA and the child was issued with a $300 fine for vaping. The parents were distressed and concerned, and worried that this approach, however well-meant by the agencies, might discourage parents from getting their children help. Can I ask the Minister of State two supplementary questions? Firstly, how closely does HSA work with the Police when a parent reports their child for vaping to a Police station? Because sometimes, parents may not be aware of what is the optimal channel. Secondly, do we know, for such cases, whether the Police when they update HSA, do they inform HSA that it was a parent who was concerned and thereby, highlighting the child's situation so that the agencies can take an appropriate approach, rather than levying a fine on a child because the parent was trying to get help for the child?”
“Mr Speaker, I thank the Minister of State for her answer. One of my Clementi residents contacted me. She said she filed a Police report, having purchased branded merchandise from a seller through the platform Carousell. She says the seller claimed the merchandise was genuine but it turned out the merchandise was counterfeit. My resident filed a Police report and was advised that the case was more of a contractual dispute and was referred to CASE. CASE told my resident it could not assist because the matter was between two private transactors. So, my resident is now wondering what redress might be possible in such situations, especially since she is of limited means and may find it hard to take up a case in the Courts?”
“But if one of the stronger commercial AI models can someday run on her smartphone, be a virtual manager or chief operating officer, that will empower her, allow her real world skills to have more of an impact. So, can MOF confirm whether the new Enterprise Compute Initiative will cover home-based businesses? Sir, in conclusion, if "Implementation is Policy", then we must look at the resident's journey as implementation. If by spending a bit more to help caregivers, we save someone's job, we must look at the benefits across Government and society. And lastly, technology must serve the people. It should not be people bending to the technology but technology lifting our people up. And so, with this, I thank my Clementi residents for their encouragement over the years, I stand proudly in support of this Budget. [Applause.]”
“In Clementi, we have a young mother who looks after a very young family, while running a home-based business. It is not easy keeping track of accounts, doing supply chain planning, designing collaterals, publicity, doing business analytics. It is a one-person operation.”
“Because Singapore has done well and it is relevant to the world, that is why people out there are interested in what we are doing, how we deal with today's challenges, how we plan for the future. People around the world are interested therefore in what our leaders are doing but also what our back benchers are talking about, backbenchers of all persuasions, all perspectives. And people around the world see what Singapore has achieved over the past 60 years. And because we are relevant, inventing the future, adapting to the challenges around us, that is why people around the world follow what our MPs say on the front bench, back bench and from all angles of this House. Let me make one more point on AI, to add to what I have said over the years. The biggest gains from AI will not be virtual. It will be when AI connects to the real world, when AI connects, empowers people in the real world doing real-world work. We must therefore democratise access to AI. It must be AI for the people, regardless of your social economic background, regardless of what you are doing, regardless of whether you are born to a tech-savvy family with lots of Internet access who can pay for the latest models, or whether you are growing up starting with less. And therefore, MOE needs to ensure every child gets the chance to learn AI, at a pace they are comfortable with and have access to good quality AI models. Access to the best AI models should not just be for the child who is born to a wealthy tech-savvy family. It must also be AI not just for big businesses with deep pockets, but also small companies or SMEs. And I would say we must also allow AI to be accessible even to our home-based businesses.”
“Sir, on technology, let me speak about AI. Sir, I have spoken on AI and technology many times over the years in this House. In 2018, during the Budget debate, I called for greater investment in AI, as well as quantum computing technology. I asked the Government as well, earlier in that year, 2018, to look at Asimov's Laws of Robotics, at that time in science fiction, but applicable in the event you have thinking machines that are able to engage and potentially even advise on human decisions. Today, from the US, we have ChatGPT, previously the GPT-4 model, now the o3 model AI model. From other companies, like xAI, we have Grok 3, new AI models from the US. From China, we have seen recently seen DeepSeek R1, advanced AI as well from China and many more AI models coming out. Just last week, Microsoft announced a new platform to have quantum computers on a chip. So, the take-home message is: technology is moving quickly, and what we think may be hypothetical questions seven years ago are real questions applicable today. In 2023 and 2024, I spoke again on AI. Parts of the 2024 speech managed to get shared online. My residents were quite excited by this. They sent me some of the links. One resident pointed out an overseas Instagram took a clip of the speech, eight million views. Another resident mentioned some X accounts, one million views. Another resident who is active on TikTok mentioned that there was an international TikTok sharing some clips, 1.4 million views. So, 10 million views or maybe more. But this is not about any individual MP's speeches. The message is people are interested in Singapore and what Singapore MPs say, because Singapore is relevant to the world.”
“It can be chaired by a senior Cabinet Minister at the Deputy Prime Minister or Senior Minister level, supported by younger officeholders and an advisory panel of public and private sector experts who understand user experience and user design, seeing through the eyes of our people, not just the eyes of engineers or coders, however they mean well; seeing through the eyes of a senior, who cannot go online to book an offline appointment in the real world with an agency; seeing through the eyes of patients and caregivers, who may be struggling to navigate the complexity of multiple apps, multiple platforms; seeing through the eyes of a young Clementi couple where hubby had to give up his work to bring his wife to the polyclinic every day because the system could not bring subsidised care to the home in the same way. Looking out for the less digitally-savvy is not just about social equity. It is not just about making sure no Singaporean is left behind. It also speaks to our social compact across the generations. Because these seniors, they spent their whole lives building Singapore up and yet, today, in the Singapore they helped build, the Singapore which is prosperous enough to go digital and have online services, there are seniors who feel left out, left behind. We must honour our seniors' contributions to Singapore, honour the seniors who made a digital smart nation possible by building Singapore in decades gone by, even as they face challenges, navigating a more digital world today. Because it also sends a message to today's middle-aged workers, today's workers who may be tomorrow's seniors. It sends a message, if we include today's seniors, that tomorrow's seniors will also be included and not left behind when there is new technology, 10 or 20 years from now.”
“Just as the IMC on Pro-Enterprise Rules Review aims to help SMEs better navigate Government rules and regulations, we should also do the same for citizens, especially our seniors who may be less digitally-savvy or who are afraid to go online, amid a world of digital scams. Because efficiency of access to services and the cost of navigating, the cost burden of time spent, it is not just a challenge for businesses. It affects any citizen who is facing difficulty navigating Government services, especially those who do not know how to go online. If helping our SMEs is important enough to have a Deputy Prime Minister chairing an IMC, then I suggest, Mr Speaker, we should adopt the same approach to helping our fellow Singaporeans, our fellow citizens navigate Government processes too and look at ways to make it as simple as possible. So, I call upon the Government: if we have an IMC on Pro-Enterprise Rules Review, we can also have an IMC on Pro-Citizen Process Review – or what we can call the Bureau Of Services Simplification; we can call it "BOSS".”
“Let me speak also about digital complexity and digital access to Government services. The importance of simplifying the journey, it applies to Government services as well. In healthcare, the more apps there are, it also means the more logins, the more apps, the more notifications, the more processes. It is not easy for caregivers and seniors. There are Government agencies which today, as a default, want the resident to login with Singpass, login online, to book an offline appointment. What happens to seniors who cannot easily go online, who have not kept their Singpass working? Has going digital made it harder for seniors to get help? And what message do we send inadvertently when we ask someone who is not digitally-savvy to go online to get the offline appointment? So, even though our agencies speak of "digital first, not digital only", we must ask: what is the outcome on the ground for our seniors? So, I call upon this Government to study deeply how the implementation of digitalisation has affected the less digitally-savvy seniors. In particular, we must look out for the risks of digital dropout. Digital dropout happens when someone who used to make use of a Government service no longer uses the service anymore because it went digital – not because their problems have gone away, but because they can no longer get to the service or find it so hard that they have given up trying to access the service. Sir, let me therefore add a call to make Government services simpler for our citizens. As background, last year, April 2024, the Government set up the Inter-Ministerial Committee (IMC) for Pro-Enterprise Rules Review.”
“Furthermore, with smaller family sizes in Singapore today, with fewer children, the caregiving responsibility is heavier for each grown up child and it is the most vulnerable workers who are hit hardest, workers who cannot do their work remotely, who cannot log in through Zoom or video conference, workers who have less bargaining power at the workplace, workers who might be daily-rated and for whom every half-day or every day taken out of work to care and support their family member, means a day in lost income, a day of economic impact. There is a cost to families, Mr Speaker, when a breadwinner can no longer maintain their full-time job. There is a cost to families when a caregiver who used to work part-time, leaves the workforce completely because of these stresses. And when a worker leaves the workforce because they can no longer juggle supporting their sick loved one through the healthcare journey and at the same time, trying to hold down their job or employment, when a worker stops working because of this invidious choice, it is not just a loss of income, it is not just a loss of being a breadwinner. Because every month that a worker stays out of work, every month that a worker has sacrificed their career for, is also a month that their skills fade, become more out-of-date. It is another month when their networks, their professional networks, their workplace networks become more distant, less connected. It becomes harder and harder, even as they make that sacrifice. So, anything we can do to streamline the care journey for our seniors, if it can help save a caregiver's employment and employability, it is something worth striving for and something that the Government can and should support even more, moving forward.”
“They share about how much effort it takes to coordinate care to try and simplify the number of clinic visits, whether it is moving multiple Specialist visits to the same day, so the patient makes just one trip rather than four, or doing backend meetings to simplify the number of visits. I have been told by our sisters and brothers in healthcare that often this coordination work takes place outside of working hours. Reaching out to colleagues, messaging, emailing, streamlining, working into the night sometimes behind the scenes – extra work, unrecorded, unmeasured. So, our agencies need to get better at recognising the amount of work that is needed to coordinate care and then to recognise that care coordination should not be seen as a cost centre and expense in and of itself, but as an enabler and a catalyst to simplify the care journey for a fellow Singaporean in need. I also call upon the Government, and especially MOF, to take a more holistic view of subsidising and funding care coordination, whether it is funding to hire more patient navigators or care navigators, or recognising additional hours put in outside of official duty hours by frontline staff who are working extra hard to coordinate for the patients and those under their care. Because simplifying the care journey can help patients and caregivers stay employed, and not have to choose between maintaining their employment, and accompanying and supporting their ill relative through the medical journey.”
“Home-based medical care, arranging for that treatment to be delivered at home could have saved my resident those trips to the polyclinic every day. It could have saved the husband's job. It could have saved his employability. It might have been counted as healthcare expenditure, additional expense on MOH's bottom line, but by saving the caregiver's job, it would have saved on suffering for the family and saved on hardship and safeguarded the husband's ability to earn as a breadwinner in his existing job. There are similar challenges throughout Singapore – caregivers under stress when a loved one is sick. In 2022, I asked in Parliament how many Specialist Outpatient Clinic visits a resident might need to go through in a single year. The 2019 figures from before COVID-19, showed that over 7,000 Singaporeans a year have to attend 24 or more Specialist Outpatient appointments in a calendar year. Sir, 7,000 Singaporeans having to go to a clinic two times or more a month. In that same year, there were over 2,000 Singaporeans who have 36 or more appointments at a Specialist Clinic every year. That means 2,000 Singaporeans averaging three or more Specialist Outpatient appointments a month. I have Clementi residents who are caregivers. They share with me how hard it can be to keep a full-time job when the family is small; not many grown up children looking after a senior who has so many medical appointments. I also have Clementi residents, as well as sisters and brothers from Healthcare Services Employees Union and they share the challenges on the other end of care delivery as well.”
“Mr Speaker, I declare I am a medical doctor at a public hospital. Cost of living is a worry for so many families across Singapore. It is the money you spend every day to get by. But there are also other hidden costs of living – the time you spend navigating public services; time that you spend, and not just money that you spend. The former Head of Civil Service, Mr Lim Siong Guan, once said, "Implementation is Policy", because the impact of policy, however well it is designed on paper, what matters is when you see what happens on the ground. And in today's world, "User Experience is Implementation" – the resident's experience is the implementation of policy. Policy cannot fully help its intended beneficiaries if the resident cannot navigate the policy, or if too many of the processes are online and the residents themselves cannot quite get online to make full use of the policy. So, again, what happens on the ground is the implementation, and implementation is policy. Let me start by sharing about some of our caregivers' struggles. I met a young Clementi couple earlier these few weeks. Husband and wife, bringing up young children. The wife just got out of hospital. Because she has a lung infection, she needs to go to the polyclinic every day to receive medication, because the nature of the medication is that she has to take it in a supervised way in a medical setting at the polyclinic. She is not well, needs a wheelchair to get around. And so, because her husband has to bring her in a wheelchair to the polyclinic every day, the husband has quit his job. The family breadwinner has quit his job and now there is no breadwinner at home.”
“Mr Speaker, I want to start by declaring that I work at a public healthcare institution, but I raise this feedback in my Member of Parliament capacity, based on what I have heard from my Clementi residents. Sir, I have got two follow-up questions for the Senior Minister of State. Firstly, the Senior Minister of State also happens to be the Minister-in-charge of the Government Technology Agency of Singapore (GovTech). Can I ask the Senior Minister of State what lessons can we learn from drawing on GovTech's experience to improve the user experience of MOH's apps and the healthcare cluster apps? For example, GovTech has a deep pool of capable staff, some who have even got experience at major international tech firms such as Google. Secondly, can I also ask the Senior Minister of State whether MOH has studied having a much more consolidated app, drawing on GovTech experience and GovTech's ease of use? Because I have residents who tell me that apps such as LifeSG and in particular, Parking.sg, are much, much easier to use than the hospital clusters apps, or even HealthHub. So, can I ask the Senior Minister of State along those lines further? Is there a lot of user interface testing done for HealthHub and the hospital apps, and is that user interface testing applied to populations, including the elderly and people who may not be naturally tech savvy? In short, Mr Speaker, seeing through the eyes of our people and not just the eyes of the engineers and coders.”
“Mr Speaker, following on from the questions raised by both myself and the Leader of the Opposition, can I ask the Minister of State, would MHA be open to engaging with academia and researchers who conduct research into such matters? Can I perhaps draw the Minister of State's attention to how there is open source research by an Australian academic team – one at Queensland University of Technology, another at Monash University – which did a computational analysis of potential algorithmic bias on a major social media platform during a major election in another country, around the world, that happened quite recently, and that there are opportunities for academia to look at this, and can the Ministry, perhaps, look at examining collaborations with academia and experts, to study this further?”
“Mr Speaker, I thank the Minister of State for her answer. Does the Minister of State not agree that much of the substance of her answer and reference to the legislation look at issues of falsehoods, rather than manipulation of viewership and what people get to see? So, can I ask the Minister of State, firstly, given that social media platforms and their algorithms control what citizens and voters see, what shows up in the feed, has the Ministry of Home Affairs (MHA) considered the following scenarios. For example, what if a foreign social media company deliberately manipulates the algorithm so that a particular candidate gets more coverage during a campaign? The candidate may not even be aware of this. Secondly, what if a foreign social media company decides to again manipulate the algorithm so that a particular candidate which they think is going to win is supported even further, so that at a later date, they can claim credit for it and perhaps even undermine the democratic mandate of that candidate and the team? These problems can affect Members of Parliament (MPs), parties and candidates on all sides, of all persuasions. So, given this, can the Minister of State share how Singapore and Singaporeans can better protect ourselves and our democracy, so that foreign social media companies do not have a situation where they manipulate algorithms to affect the outcome of our democratic process, so that politics in Singapore remains for Singaporeans to decide?”
“Mr Speaker, I thank the Ministers for their replies. I filed three PQs on this. First of all, can I ask the Ministers: at the whole-of-Government level, would they not agree that implementation is policy – and that is actually a quote from a former Head of Civil Service, Mr Lim Siong Guan. To build on that, would they, furthermore, also consider that implementation must recognise contemporary reality as well as emerging reality that the policy has to operate in? Secondly, can I also ask the Ministers, moving forward from what has happened here, the bell cannot be unrung, information that has been released cannot be unreleased. But moving forward, will our agencies very actively look at how the world has changed and is continuing to change? For example, how today online bots can scrape thousands or even millions of data points if a search engine delivers the information quickly; that there are scammers and hostile actors hoping to harvest every database they can get their hands on, anything with an application programming interface, or API, that can be accessed. And lastly, given all of this, whether there can be continued deep attention in the review to how in Government e-services, we approach aggregates of data, especially when that data can be searched by the public or persons even from outside Singapore.”
“I thank the Senior Minister of State for her answer. I have a Clementi resident who, for over a year, had food waste thrown out from a unit some floors above and was told that his block, which is one of the Clementi central blocks, because of the design, despite good grounds for suspecting which unit was responsible, NEA's existing technology could not actually target the window where the high-rise litter was coming from. And worse still, it appeared that the suspect unit knew this and, therefore, felt a sense of impunity. Can the Senior Minister of State tell us, how soon these better cameras, less obvious cameras, more flexibly-orientable cameras, how soon can these be deployed? And if hot spots can be prioritised, especially where there is considerable disamenity from high-rise litter? Likewise, there are one or two spots in the Clementi area where there have been incidents of faeces being thrown from a high-rise window or sanitary pads and some of these have been ongoing for a while. We hope for NEA's support in addressing these issues.”
“But if it comes in, we will take strict enforcement and we want to make sure that we disrupt as many syndicates or efforts to harm our people, as much as possible.”
“Mr Speaker, the Minister of State answered just now that a vaping device will come under section 9 of the MDA if it can be shown that the device is being used for a controlled drug or drug of abuse. Can I ask the Minister of State, how do agencies know in advance if a vaping device – which, by the way, is already illegal – contains nicotine or contains ketamine or some other controlled illegal drug? Does it depend on how prevalent the substance is? Can I ask the Minister of State, should we not act now before these controlled drugs in vapes become more prevalent, before they reach the one in six that happened in another country that Member Mr Zhulkarnain highlighted, so as to keep our people safe and to keep our children safe for the future? Assoc Prof Dr Muhammad Faishal Ibrahim: Sir, I thank the Member again, for his deep concern about the issue. As I shared earlier, we are not waiting. We are already doing. We also understand the overseas landscape, so, we work together with our counterparts. The nature of drug-related offences or even the kind of investigations we do depends on a lot of intelligence as well. So, it is not as simple as knowing what is controlled or not controlled drugs or nicotine. At the end of the day, it is about how we can work together with the agencies and how we work together with our counterparts. And, as Members know, it is not easy to detect, but our CNB colleagues have worked very hard and they will continue to work hard to make sure that as much as we can, we will protect our shores, as much as the syndicates want to bring in, we also want to work hard to ensure that it does not come in.”
“So, they are also interested to work with us and we want to get more like-minded people and countries to work together to ensure that not only Singapore is safe but the world will be safer so that we can keep the harms of drugs from our people.”
“Assoc Prof Dr Muhammad Faishal Ibrahim: Sir, I thank the Member for sharing his and his residents' concerns about the developments taking place with regard to the use of vapes related to drug consumption, possession or even trafficking methods. Sir, as I shared earlier, the possession of any apparatus or article, including vapes, for the consumption of controlled drug is an offence under section 9 of the MDA. This is something that I have shared earlier. What is key is that we see globally, that there has been a rise in the liberalisation of attitudes and also decriminalisation relating to drug offences. However, in Singapore, we continue to have a strong stance. Sir, I would like to thank Members here as well as fellow Singaporeans for working together with us in fighting the scourge of drugs. At the same time, we are not stopping there. Recently, we formed an inter-Ministry committee (IMC) on drug prevention for youths, where we work with the different agencies to go upstream so that our young people and our society not only are aware but know what to do when they come across issues or physically coming across drugs. These are important efforts that we must take on together. Globally, for drugs, it has become a dangerous setting. But in Singapore, we are also working with like-minded countries to ensure that first, we keep our people safe from the harms of drugs. So, we work with counterparts and over time, you realise that even countries which have liberalised their policies, have come to realised that they are not able to control it. I have met my counterparts who shared with me that, it happened very slowly, but it has damaged and destroyed their people.”
“Mr Speaker, I thank the Minister of State for his answer. Sir, a young Singaporean with family in Clementi wrote to me. She is 13 years old and is worried about vaping catching on in schools. A young Clementi resident, 16 years old, told me how they are worried about vaping pods having illegal drugs or even controlled drugs getting into Singapore, because there are advertisements online overseas for how it can be done. So, can I ask the Minister of State two supplementary questions? Firstly, does the Minister of State agree, given what is happening around the world, that vaping devices are dual use? They can be used to fuel nicotine addiction or they could be used to administer controlled illegal drugs; and if so, will the Ministry consider gazetting vaping devices as gateway devices, given they could be used for both on the ground, which is happening in some parts of the world? Secondly, the Minister said that the MOH agencies, including HSA, and the Ministry of Home Affairs (MHA) agencies, such as CNB, are working together and refer cases to one another. Sir, can I ask the Minister, if you cannot be completely sure upfront whether a vaping device is going to be used for nicotine or for a controlled drug, why has MHA not taken more of a lead on this so that MHA resources can better support MOH and HSA, and ensure that we do not become a nation where gateway delivery devices are available widely? Because that will open us up to the risk of foreign drug dealers and foreign drug pushers getting into our heartlands and schools through vapes as a gateway device.”
“Mr Speaker, I thank the Senior Minister of State for his answer. I recall asking the Senior Minister of State last year if SingPost, the private company, have some de facto public service role, given the role of post offices in the Immigration and Checkpoints Authority passport collections today and distribution of masks during the COVID-19 pandemic. I have got two related questions for the Senior Minister of State. Firstly, given what happened to SingPost's leadership, does the Senior Minister of State agree that the health of the brain and heart of a corporation can also affect other organs and other limbs of the corporation as well? And if so, is there any concern that what is happening to the unregulated international part of the business might eventually spill over to affect the regulated domestic part of the service business? Secondly, can the Senior Minister of State elaborate on what IMDA is doing to find out what happened at SingPost, to ensure that SingPost's staff morale is maintained, especially on the ground and that management is not distracted from the essential services aspect of post office service provision in our heartlands, including for our Clementi residents?”
“Over the last four years, SingPost has performed within the QoS standards. I would also assure Mr Saktiandi Supaat that postal services for legal notices and court orders are not affected. While the whistle-blowing report did not affect regulated domestic postal services, we were concerned, as Dr Tan Wu Meng was, about simultaneous dismissals of senior executives in a firm providing essential postal services. Hence, IMDA had issued SingPost an advisory to uphold proper corporate governance and processes, given its PPL status. Third, on Mr Pritam Singh and Mr Louis Chua's questions on how this affects the postal sector review, the answer is that it has not and the review is ongoing. IMDA will continue to work closely with the CEO of SingPost's Singapore Business Unit, who remains in the role. Our postal services have to transform to remain sustainable and accessible while safeguarding the interests of the public and postal workers.”
“Question No 43. The Senior Minister of State for Digital Development and Information (Mr Tan Kiat How) (for the Minister for Digital Development and Information): Mr Speaker, may I have your permission to address Question Nos 43 and 74 for oral answer in today's Order Paper? My response today will also cover the questions filed by Dr Tan Wu Meng1, Mr Zhulkarnain Abdul Rahim2 and Mr Pritam Singh for a subsequent Sitting. If the Members are satisfied with the response, they may wish to withdraw the questions after this session. I will answer the following questions raised by Members. First, what is the substance of the whistle-blowing report? Second, are domestic postal services affected? Third, does this affect the review of postal services? First, what is the substance of the whistle-blowing report? The report concerned the alleged falsification of e-commerce shipment data for a SingPost customer. The Infocomm Media Development Authority (IMDA) had assessed and was satisfied that the incident was confined to international transshipment parcel delivery overseas and did not affect regulated domestic postal services. This is a matter of corporate governance, which the SingPost board is dealing with. Second, are domestic postal services affected? As mentioned, the answer is no. SingPost's board has assured the Government that postal service operations are not affected. Nonetheless, IMDA will continue to keep a close watch to uphold the public's interests. As the Public Postal Licensee, or PPL, we expect SingPost to meet its obligations for its regulated postal business. These include ensuring that domestic letter delivery meets IMDA's Quality of Service, or QoS, standards. SingPost's QoS performance is independently audited and the results are published on IMDA's website.”
“Question No 1. The Senior Minister of State for Digital Development and Information (Mr Tan Kiat How) (for the Minister for Digital Development and Information): Mr Speaker, Question Nos 1 to 37 in the Order Paper today relate to the Government policy on National Registration Identity Card (NRIC) numbers and the recent incident where the numbers were disclosed on the Accounting and Corporate Regulatory Authority (ACRA) BizFile Service. The Minister for Digital Development and Information Josephine Teo and the Second Minister for Finance Indranee Rajah have given notice that they will be delivering Ministerial Statements on these topics tomorrow, 8 January. As their Ministerial Statements will be addressing the issues raised in these Parliamentary Questions (PQs), I ask your leave for these PQs to be deferred for answer via the Ministerial Statements on 8 January.”
“Mr Speaker, I thank the Minister of State for her update. She mentioned the use of MediSave for young cancer patients needing help with fertility preservation. Would the Minister of State, firstly, agree that for some young cancer patients from families of limited means, especially if the patient has not yet started work, that patient may not have much MediSave? And if the family is disadvantaged, the family may also not have much MediSave. And therefore, would the Minister of State also agree this is an issue on the ground that the Ministry of Health (MOH) should look at, to ensure that young patients diagnosed early in life with cancer, regardless of background, have that chance at preserving their dreams of a family? May I also declare as well that I am a medical doctor looking after cancer patients, including young cancer patients, at a public hospital.”
“Can I ask the Minister, in his assessment of the current landscape of TAFEP cases on unfair HR practices, roughly what proportion of cases did the adjudication hinge on proof of intention by the hiring manager or the company's management? Because with AI, it can be difficult to ascertain intention because the AI is not able to give testimony and be cross-examined or provide information for investigation the way a human can be questioned.”
“Mr Speaker, I thank the Minister of State for his answer. I have Clementi residents who are ageing and so are understandably giving much attention to whether our bus services, our bus infrastructure continue to be accommodating of the elderly. Can I ask the Minister of State, in the stakeholder consultations, will there be attention given to engaging healthcare professionals who work with the elderly and may have insights into the challenges faced by the elderly? Professionals such as geriatricians, physiotherapists, occupational therapists and other allied health professionals with relevant experience.”